How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | None | $10.72 | $10.72 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | RR · Rental | $1.07 | $1.07 | $1.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | UE · Used equipment | $8.13 | $8.13 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $15.14 Typical High $16.22 | Facility | None | $14.79 | $15.14 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | None | $12.88 | $12.88 | $15.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.91 Median $18.62 Typical High $24.55 | Professional | None | $8.91 | $18.62 | $24.55 |
Martin's Point Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
United Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $29.51 | Professional | None | $8.32 | $10.72 | $29.51 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.23 |
Where Maine sits
The same service costs 3.5 times more in Hawaii than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maine· 47th of 51
$11.75
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.